NSAIDs, Part 3: The rise, fall and rise again of COX-2 inhibition

ByAdam J. Brown, MD

In the third episode of the NSAIDs saga, we focus on COX-2 inhibition! Did the hopes and dreams of selective COX-2 inhibition pan out? What can the rise and fall of VIOXX teach us about physiology?

Intro 0:11
Recap of part 1 & 2 0:28
In this episode 1:44
Cyclooxygenase 2 (COX-2) and the rat experiment 3:12
What do we know about the prostaglandins? And what about COX-2 7:54
What does prostacyclin do? 10:33
The first COX-2 inhibitor: VIOXX 10:56
What is COX-2 doing?: Pfizer and Merck 12:15
Two more NSAID studies: colon cancer, Alzheimer’s disease and COX-2 inhibitors 18:41
VIOXX: Why is myocardial infarction risk occurring? 22:34
Animal models and the Goldilocks theory of thromboxane and prostacyclin 23:49
PRECISION trial 30:25
Rheum + Boards 37:14
Thanks for listening 37:32